This invention relates generally to the treatment of nasal hemorrhages, and more particularly to an article and a method for treatment of posterior nasal hemorrhages.
Epistaxis or nasal hemorrhaging which requires packing of the nose is a common phenomenon, since branches of several major arteries are located quite close to the surfaces of the nasal cavity. Anterior hemorrhaging is relatively easy to treat by a physician because the site of the bleeding can be visually ascertained and manually treated. One of the most common methods of arresting such bleeding is chemically to cauterize the area and then insert an absorbent packing material, such as gauze or cotton, into the nasal chamber. Early workers in the art such as Sandmark, U.S. Pat. No. 1,051,850 and Beck, U.S. Pat. No. 1,235,095, utilized inflatable soft rubber balloon-like devices in place of gauze or cotton packing.
Posterior nasal hemorrhaging presents more difficult treatment problems since the source of the bleeding is both difficult to ascertain and difficult to pack properly to arrest the flow of blood. Anterior packs cannot control this type of hemorrhaging. A typical prior art procedure involves inserting flexible catheters into both nostrils of a patient through the nasopharynx and into the oropharynx. There the catheters are grasped by forceps and pulled out through the mouth. Sutures are then attached to the catheters and to a nose pack--either a piece of rolled up gauze or a tampon--and the opposite ends of the catheters are pulled slowly out of the nostrils causing the pack to move into the nasopharynx. With continued pulling of the catheters and the aid of the index finger of the physician, the pack is pulled up to a position superior to the soft palate and positioned around the posterior edge of the septum. The sutures are then tied off to hold the pack in place, and the nasal cavity is then packed by feeding gauze or other packing material into a nostril.
There have been several attempts to improve upon the basic posterior nose pack. For example, Fortay, U.S. Pat. No. 3,420,237, utilizes a thin tape of rubberized material covered by a sleeve of gauze which is positioned around the posterior end of the septum by drawing the tape through the nasal passages by use of a catheter. Walker, U.S. Pat. No. 3,884,241, provides a small, hemispherically shaped piece of foam rubber positioned posteriorly of the soft palate which acts as a stopper to prevent gauze packing in the nasal cavity from falling into the pharynx. Kriwkowitsch, U.S. Pat. No. 3,049,125, Ruggero, U.S. Pat. No. 3,516,407, Gottschalk, U.S. Pat. No. 3,570,494, and Pidgeon, U.S. Pat. No. 3,766,924, all show variations of inflatable balloon-like elements designed to be placed in a nostril and inflated to arrest nasal hemorrhaging. Doyle, U.S. Pat. No. 4,030,504, describes a porous tampon which is designed to be inserted into a nostril where it expands to assume generally the shape of the respective nasal cavity.
However, none of the above prior art devices or procedures have proved to be entirely satisfactory. Because of the nature of posterior nasal hemorrhaging, it is difficult if not impossible to pinpoint immediately the source of bleeding. Prior art devices designed to fit into a single side of a nasal cavity may or may not be effective in arresting the flow of blood depending on whether the device is inserted into the correct side of the cavity. Even if the device is inserted into the correct side of the nasal cavity, it may fail to provide proper hemostatic pressure to the ruptured blood vessels because of the numerous protruding bony areas (turbinates) in the nasal cavity underneath which blood vessels are hidden. Accordingly, the need still exists in the art for a device which will effectively arrest posterior nasal hemorrhaging by applying hemostatic pressure to all areas on both sides of the nasal cavity.